In Germany, donating your organs is voluntary, and while around 60 percent of people say they think its a good idea, just 14 to 17 percent of them have become organ donors. Advocacy groups are trying to raise awareness about the problem and encourage people to become donors.

There are currently some 12,000 people waiting for organ transplants in Germany and each year between 2 and 3,000 of them will die before they can make it to the top of the list..

According to the British National Health Service, organ transplantation is the most cost-effective treatment for end-stage renal failure. For end-stage failure of organs such as the liver, lung and heart, transplantation is in fact the only available treatment.

Lack of Awareness

There's a poster campaign all over Berlin featuring well-known celebrities to try to raise awareness about organ donation, so it seems surprising that some people haven't heard about it.

Before she had a heart transplant, Ute Opper, 45, would have been among them.

"I did not know anybody who needed an organ. Nobody talked with us. Not in school, and not when I did my driving license", she said.

17 years ago Opper suddenly became seriously ill just four weeks before her wedding. Diagnosed with endocarditit, an inflammatin of the heart muscle. After a failed operation on the infected valve led to a heart attack, she was told that her chance of survival required a heart transplant. Opper was lucky and only had to wait a year to receive her new heart.

After this experience, Opper and other patients created a self-help group to support people waiting for organ transplants. She also educates the public to "try to make people who never thought about that, think about it."

"We want to have people imagine you also could be ill and maybe you would need an organ," she said.

Addressing the Problem

Despite the introduction of the German transplant law in 1997, the rates of organ donation in Germany have been steadily dropping. According to Professor Dr Roland Hetzer, Director of the German Heart Institute in Berlin, there are two main reasons for this. The first is convincing the public that organ donation is a good idea, while the other problem is a lack of infrastructure.

"Not all hospitals cooperate well enough in reporting brain-dead people who would be potentially an organ donor," said Hetzer, "and this obviously has to do with the increasing economic problems that hospitals are faced with."

Spain is the world leader, not only due to it's model of presumed consent, but because it has designated staff that only deal with organ donations. Dr Hetzer believes that Germany would have a higher number of transplants if it too had designated staff.

Controversy

Cardiac surgeon, Dr Reinhard Daniel Pregla, is working hard on public campaigns to increase the number of organ donors in Germany, but at the same time he would like to see the EU-wide adoption of stronger models like that of presumed consent used in Spain, Austria and Belgium, or Israel's new law that prioritises organ donors.

Across the European Union there are 60,000 people waiting for organ transplants. According to Dr Pregla every citizen in the EU should have to decide either he or she wants to be an organ donor.

"And if he denies to be an organ donor it should have the consequence that he has less right to receive an organ," he said. "Not that he should not receive an organ, but the priority should be more on those people who are willing to donate organs."

Dr Pregla said that one person can save the lives of five others and that people need to take that into consideration.

"This has to be valued if people decide to do this. It can't be that in general we have the right to take, but not the duty to give. This has to be connected in some way," he said.

Such models have been proposed before, but Dr Hetzer said they are regarded as unconstitutional in Germany, where the right of the individual is clearly outlined in the constitution.

Even though Ute Opper agrees that the Israeli policy and that of presumed consent helps gravely sick people waiting for organs, in her opinion she believes that it's better to educate and inform people and to give them the right to choose.

"It's a gift. A new organ is a gift. And you should say it's my body and if I want to give something away I think I should say that I want to do it," said Opper.

EU Directive

Things are changing in Europe. The EU Directive on Organ donation and transplantation, approved last month, aims to standardize organ procurement and traceability, thereby increasing the availability of organs across the 27 EU member states and reducing organ trafficking.

With so many people desperate for organs, some who have sufficient funds turn to the black market. Freelance journalist, Seem Sanghi, says that perhaps if more people gave their consent to donate their organs, maybe it would stop organ trafficking in places like India where people from the villages move to the cities with the promise of work.

"Then they're knocked out and their organs are taken out without them knowing," Sanghi explained.

While the EU directive, which will be implemented across the member states over the next two years, will have no direct effect on how organ donations are procured in places like India, people like Sanghi hope making easier for Westerners to get a new heart or lung will take pressure of the developing world.

Author: Cinnamon Nippard
Editor: Mark Mattox